Etiology-related determinants of liver stiffness values in chronic viral hepatitis B or C
| Autor: | Pietro Lampertico, Mirella Fraquelli, Guido Ronchi, Giovanni Casazza, Dario Conte, Maria Francesca Donato, Cristina Rigamonti, Maria Grazia Rumi, Massimo Colombo |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Adolescent Biopsy Chronic liver disease Gastroenterology Young Adult Hepatitis B Chronic Internal medicine medicine Humans Aged Hepatology medicine.diagnostic_test business.industry Liver cell Standard of Care Hepatitis C Hepatitis C Chronic Middle Aged Hepatitis B medicine.disease Fatty Liver Liver biopsy Linear Models Elasticity Imaging Techniques Female Steatosis business Viral hepatitis Transient elastography |
| Zdroj: | Journal of Hepatology. 54:621-628 |
| ISSN: | 0168-8278 |
| DOI: | 10.1016/j.jhep.2010.07.017 |
| Popis: | Transient elastography (TE) has gained popularity for the non-invasive assessment of severity of chronic viral hepatitis, but a comprehensive evaluation of the factors that might account for discrepancy in diagnostic accuracy between TE and the standard of care liver biopsy (LB) is still needed.Patients with chronic hepatitis-B (HBV, n=104) or -C (HCV, n=453) underwent percutaneous LB concomitantly with TE (FibroScan®; Echosens, Paris, France). Liver cell necroinflammatory activity (A) and fibrosis (F) were assessed by METAVIR. Perisinusoidal fibrosis was rated with a 0-3 score. Determinants of TE results were investigated by a linear regression model whereas discordance between TE and LB results was assessed by logistic regression.Fibrosis (p0.0001) and liver cell necroinflammatory activity (p0.0001) were independently associated with TE results in both HBV and HCV patients, whereas steatosis (p0.0001) was independently associated with TE in HCV only. Fibrosis overestimation was predicted by severe/moderate necroinflammatory activity in HBV and by older age (41-60 or60years vs.40),2 UNL AST and2 UNL GGT, as well as severe/moderate necroinflammatory activity and severe/moderate steatosis in HCV. In the latter patients, however, moderate/severe necroinflammatory activity and steatosis were the only independent predictors of fibrosis overestimation.Fibrosis and necroinflammatory activity are the main determinants of TE in chronic viral hepatitis. Since TE staging of fibrosis is influenced by necroinflammatory activity and steatosis, a diagnostic LB is deemed necessary for a reliable intra-patient TE monitoring of the course of viral hepatitis. |
| Databáze: | OpenAIRE |
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